Providence Pediatric Dentistry and Orthodontics

Airway Orthodontics

What is Airway Orthodontics?

At Providence Pediatric Dentistry & Orthodontics, Orthodontics is a lot more than just straightening teeth and creating beautiful smiles. We are focused on the overall health of our patients. One specific area this philosophy becomes important is when a child has a crowded or crooked smile, or a narrow upper jaw.  This is a sign that the jaw is not growing properly.  Certain oral habits and jaw deformities can lead to Obstructive Sleep Apnea (OSA) and Sleep Disordered Breathing (SDB).  Airway Orthodontics refers to orthodontic treatment methods used to expand a patient’s airway in order to treat OSA and SDB and prevent further destruction caused by these two disorders.

What is Obstructive Sleep Apnea (OSA) and Sleep Disordered Breathing (SDB)?

Obstructive Sleep Apnea occurs when the airway closes sufficiently during sleep and breathing stops.  This triggers release of cortisol (the “fight or flight” or “survival” stress hormone) that increases heart rate and activates muscles to force breathing.  Although the person doesn’t actually fully wake up, they are driven from deep restorative sleep to “catch their breath”. Once they begin to relax to the deeper levels of sleep, it happens all over again.

This is hard on the body, imagine running a race all night long. You wake up exhausted and unrested, but more importantly, prolonged levels of increased cortisol negatively affects the immune system, normal hormone production, insulin function, gastric acid production, learning and memory retrieval, and a host of other organs and body functions.

Symptoms of OSA & SDB

  • Snoring
  • Mouth Breathing
  • Enlarged Tonsils/Adenoids
  • Facial & Jaw Deformities
  • Restless Sleep & Drowsiness During the Day
  • Moodiness
  • Short Attention Span or ADD/ADHD
  • Bed Wetting
  • Tooth grinding/clenching

Causes

The most common and significant causes of OSA and SDB are:

  • Obstructive tissues (enlarged tonsils, adenoids, turbinate bones (in the nose), deviated septum)
  • Poor tongue posture & tongue thrusting
  • Tongue/oral anatomy (narrow jaws, recessive upper and lower jaws, tongue-tied)

Airway Assessment

Dr. Kaitlin assesses each patient at their initial and recall exams for potential airway-related issues/symptoms.  

Dr. Adam includes a comprehensive airway evaluation at each orthodontic consultation. This includes:

  • Measuring airway on a 3D X-ray.
  • Checking for any symptoms of OSA & SDB
  • Evaluating tonsils and adenoids for any enlargements on a 3D x-ray and clinically.
  • Evaluating oral and tongue anatomy (ex. presence of a tongue or lip tie)

Treatment

We treat airway-related symptoms with these three methods:

  • Growth-oriented Orthodontics (orthopedic jaw expansion, advancement of upper and/or lower jaws to create room for the tongue and open the airway) rather than pulling teeth.
  •  Tongue-Tie Release Procedure (if patient has moderate-severe tongue tie that is affecting tongue posture and causing mouth breathing)
  • Reduction of obstructive tissues (Remove Tonsils/Adenoids, allergy correction or naturopathic) Research has shown that the best results occur when both are done!

When to Assess and Treat?

As soon as you are aware of the problem! Although 7-8 years of age is an important age for orthodontic correction, we can make a big difference in 3- to 6-year-olds with some simple and timely care. Dr. Adam and Dr. Kaitlin are “airway-focused” specialists and very passionate about approaching airway issues as a team to provide the best treatment for our pediatric and adult patients!  They often work together with an Ear-Nose-Throat (ENT) medical specialist, myofunctional therapist, and/or speech pathologist to provide the best possible care, and will make a referral to any of these specialists as necessary.  Contact our office today for a complimentary consultation and airway exam!